Bilateral Refractive Lens Exchange with a Hydrophobic Trifocal Intraocular Lens

To evaluate the visual and refractive outcomes in patients who underwent bilateral refractive lens exchange (RLE) with the trifocal hydrophobic FineVision HP IOL.

This prospective, single-center, non-comparative study enrolled 70 eyes of 35 patients implanted bilaterally with the FineVision HP IOL (Beaver-Visitec International, Inc. USA). Postoperative outcomes at 3 months included manifest refraction, monocular and binocular logMAR uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance-corrected intermediate visual acuity (DCIVA, at 60 cm), and distance-corrected near visual acuity (DCNVA, at 40 cm). The binocular defocus curve was also registered.

94.29% of eyes showed a spherical equivalent within ±0.50D and all within ±1.00D. 95.71% of eyes showed a refractive cylinder of ≤0.50D and all ≤1.00D. The mean spherical equivalent and refractive cylinder were 0.16 ± 0.27D and -0.18 ± 0.21D, respectively. Mean binocular CDVA, DCIVA and DCNVA were -0.12 ± 0.06, 0.15 ± 0.07 and 0.03 ± 0.05 logMAR, respectively. 88.57% and 100% of patients achieved a cumulative binocular CDVA of ≥20/16 and ≥20/20, respectively. Furthermore, 51.43% and 91.43% patients achieved a cumulative binocular DCIVA of ≥20/25 and ≥20/32, respectively; and 71.43% and 100% of patients achieved a cumulative binocular DCNVA of ≥20/20 and ≥20/25, respectively. The safety and efficacy indexes were 1.07 and 1.01, respectively. The defocus curve showed a peak of maximum visual acuity, better than 20/16, at distance, with a continuous smooth reduction in visual acuity for intermediate distances, followed by a secondary peak close to 20/20 at near.

The FineVision HP IOL demonstrated favorable short-term refractive accuracy and visual performance in this prospective cohort, although larger comparative studies with longer follow-up are warranted.